Provider Demographics
NPI:1689883548
Name:SIFAKIS, DEMETRA MAKRIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEMETRA
Middle Name:MAKRIS
Last Name:SIFAKIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:DEMETRA
Other - Middle Name:VASILIA
Other - Last Name:MAKRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2901 WEST BELTLINE HWY.
Mailing Address - Street 2:STE. 120
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-4226
Mailing Address - Country:US
Mailing Address - Phone:608-443-5500
Mailing Address - Fax:608-441-1981
Practice Address - Street 1:3434 E. WASHINGTON AVE.
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-4155
Practice Address - Country:US
Practice Address - Phone:608-443-5550
Practice Address - Fax:608-443-5554
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54486122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist